Difference bw assisted living and nx home?Assisted living job 42 pt per nurse, safe?

[seneyka]

I could not imagine I would have to face the fact about the staff:pt ratio.

One care and rehab job before I was offered had a ratio of 1:30, $25/hr. CNA and treament nurses also included in the staffs. I turned it down because my first thought was that this is unsafe staff pt ratio.

Now another job offered in an assisted living facility with 3 aids (CNA), 1 nurse manager, and 1 LPN with 42 pts (not sure whether there is any treament nurse). And the pay is a less than the 1st job offered above: $21/hr.

I did research about ratio 1:30 and understood that forum members of this website had discussed that the ratio is unsafe but not unusual. That was why I did not accept the job.

NOw it's 1:42! Oh my! I dont know how I am gonna deal with this heavy load!

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My concern are:

1. "What is assisted living?"

2. "Do pts in assisted living have less severe medical conditions than those in just general LTC?"

3. What are the ranges of pt loads from the least and the most amount of pt you've encountered or known or experienced?

4. Based on #3, is this ratio 1: 42 safe, esp. in assisted living?

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Thanks for reading and sharing,

[seneyka]

I worked in an ALF a couple of years ago. One 1st shift, there were 3:30-40. On 2nds, it was 2:30-40. On 3rds, it was 1:the whole building. (60+/-). We did med reminders, as we not supposed to handle the meds. They were required to be in an organizer and we simply opened it and "dumped" the meds into the res. hand. We also assisted with showers, dressing, did laundry, dishes, took out trash, and light housekeeping. We also took people to and from the dining room, changed briefs, and passed the dinner trays to those who "stayed in" for meals. We had no certification, and were paid $7.50/hr to start. !

Those descriptions sound like for CNAs.

I am an LPN.

Usually with certification such as CNA, the starting wage in WA is $10, up to $18 with many yrs of experience.

Thank you for sharing!

[turtle rain]

Hi Suesquatch,

Thanks for the valuable information. I am not an LPN yet and this would be my 1st health care position. I spoke in length with the human resources person and they seemed very excited about keeping me on staff once I pass boards - hopefully in summer of '09. This facility seems like a good place to start. I'm supposed to be in training next week....do you have any additional advice?

[litbitblack, ASN, RN]

I worked assisted living living prior and during nrsg school. I assisted with meds to about 40 residents. we did 2 hr checks. helped with assigned showers and bath days. served breakfast lunch and dinner. did laundry on assigned days. I loved it. its what i was doing when i decided to be a nurse. the nurse wasn't there all the time, but there was a nursing home part that if something happened that nurse responded to the whole building. the nurse assigned to the assisted livng part set up meds in the containers for us to pass out and basically kept up with the doctors and stuff. ITs assisted living. your just assisting them in their living situation whatever it may be. some were on oxygen, one was blind, two slightly confused, one needed assistance to the br every two or so hours. you actually get to know your residents and thier families. I think you really need to have some kind of assessment skills though so you can pick up on things that the aids might not be aware of. it would be to the benefit of the residents if the nurse had some experience.

[Miss Cola, BSN, RN]

I started working at an ALF 6 months ago-my first job as an LPN. So far, I feel like I made a great decision. I have to admit though, I was looking for work about 3 months and I happened to stumble upon this job by accident. At the time I had no clue what an ALF was-I was so desperate to get out into the field, I probably would have given anything a try!!!!

Now that time has passed and I've settled in, I know I am in the right place at this point in my life. At first when I started I continued looking for a job at a SNF, to get more experience. I didnt want to sell myself short and I wanted to gain all the experience I could possibly get. Then I talked to a few of my old classmates and I could easily tell that they were stressed and overworked their SNFs, always short staffed, going crazy every day. Then I started getting to know my residents and now I love them so much. I stopped looking for anything else. I love my job, I love my position. I look forward to going to work to see my residents, they brighten up my day!!!! Eventually once I get my RN I will change fields, but for now, I am very content.

Depending on what kind of licenses the ALF has makes a difference in what you do there as an LPN. We can not have a resident with more than a stage II, a foley, we can not have any lift equipment, home health comes in to do drsg changes regularly (we do any in-between care) I am the only LPN on staff on my shift, there are 4 CNAs 1 medtech and 98 residents. Some are self-medicated, some have private duty aids, most need help with remembering pills, some need neb txs, insulin, and creams. Every now and again someone falls and injures themself, or has some other emergency and we send them right out-thats it in a nutshell.

I am glad I have the opportunity to "ease" into the profession, Im sure an ALF is a different atmosphere-not as fast paced as a SNF- but I am greatful for this bc it allows me to go to school to for my RN and not have so much stress and the horrible hours as other places.

The facility you choose, whether a ALF or SNF, really depends on what you are looking to do and what fits best into your life. Hope someone finds my info helpful in some way!!!

[ns lpn]

The assisted living facility I work in is only staffed 8-4 by one LPN (1:21). It is attached to a LTC facility which offers only emergency care/medication delivery/Treatments after hours. It is the families responsibility other wise to see they are cared for after 4pm. Problems arise when pt's health turns unexpectantly and they need 24hr care but usually they get sent to OPD and we r/f to re-admit when this occurs...sad but true. Some of my pt's are almost completly independent and others need meds, baths, meals, pysio ect...

In a week you could have a day there is little to do and the rest you could be non-stop it really depends on the pt's health mental and physical.

From what I can see the 'assisted living' title can be very different from one place to the next and I would be trying to research as much as possible about each one before working in them.